About Chiropractic
Find a DC
For Members
Legislation
Washington Chiropractic Trust
Plexus
Ads
Calendar
Chiropractic in the News
HIPAA
Local Societies
Sports Council
Insurance
Agencies & Commissions
Research Studies
Advertise

Insurance Commissioner and Secretary of Department of Health Deny Rule Making Petitions

In September of this year the WSCA filed 8 rule-making petitions with the Office of the Insurance Commissioner (OIC), and we cross-filed three of them with the Department of Health (DOH). Both state agencies had 60 days to respond to our petitions and either accept, modify or deny.

In early November we received responses from both state agencies. The OIC denied seven of the eight petitions stating they did not have authority to promulgate the proposed rules we requested. They agreed to move forward on our petition filed as #101, regarding locum tenens coverage, and we expect a hearing scheduled some time in the first quarter of 2006.

WSCA also received a response from the Department of Health denying the three petitions that we cross filed, #202, #207 and #208, all related to competition in the market.

The WSCA Board of Directors has met and reviewed the responses from the two agencies and is now preparing bills for the 2006 legislative session.

Insurance companies are so big that when you are not allowed into a provider panel, for no other reason than they don’t want to add you, the provider is not able to compete in the market. When you are not allowed appropriate office coverage your patients lose their ability to have appropriate continuity of care. And, when you are not allowed due process when you disagree with an insurer you are penalized and treated unfairly.

The WSCA Board of Directors has made these issues a high priority for chiropractors in Washington State, and we will continue to work through all of the options available to us for the appropriate remedy.

The response documents sent between the WSCA and the two state agencies. Updates will be posted to our website at www.chirohealth.org as they occur.

Thank you for your continued support of the WSCA.

The following documents make up the formal rule-making filing with the Washington State Insurance Commissioner, and the Washington State Department of Health. The PDF documents are the forms filed with brief descriptions of each proposed rule, with some rationale. The WORD documents are the actual rule that is currently in place; our proposed language is identified with underlined text in the document. The letters to the Insurance Commissioner and the Secretary of the Department of Health, and the exhibits, provide supporting materials for additional rationale.

Petitions filed with the Office of the Insurance Commissioner on September 8, 2005:
Letter to Honorable Mike Kreidler,
Washington State Insurance Commissioner

Letter to OIC

101. Require health carriers to recognize “locum tenens” in the chiropractic profession to the same extent as health carriers recognize “locum tenens” for physicians.


101 Petition

101 Proposed Rule

102. Prohibit health carriers from tying practitioner participation in one product offering to practitioner participation in other product offerings.


102 Petition

102 Proposed Rule

103. Prohibit health carriers from refusing to do business with chiropractors who purchase a retiring chiropractor’s practice.


103 Petition

103 Proposed Rule

104. Require health carriers to amend their dispute resolution process with chiropractors to allow an independent outside review of payment disputes.


104 Petition

104 Proposed Rule

105. Require health carriers to clearly disclose the method and amount of prospective payment for services before a chiropractor signs a contract with the carrier or agrees to participate.


105 Petition

105 Proposed Rule

106. Require health carriers to contract with groups of five (5) or more practitioners to the same extent as health carriers recognize group contracting for physicians.


106 Petition

106 Proposed Rule

107. Prohibit health carriers with a statewide market share of more than 20% from terminating a chiropractor except for cause.


107 Petition

107 Proposed Rule

108. Require health carriers with a statewide market share of more than 20% to contract with chiropractors who meet the carrier’s credentialing standards.


108 Petition

108 Proposed Rule

OIC's reponse to these petitions

WSCA's counter response to OIC >>


Petitions cross-filed with the Department of Health on September 8, 2005:
Letter to Mary Selecky, Secretary of State, Washington State Department of Health
Letter to DOH
202. Prohibit health carriers from forcing chiropractors participating in a carrier's health plan to also participate in every other plan, program and arrangement marketed by the carrier.
202 Petition

202 Proposed Rule
207. Prohibit health carriers with a market share of excess of 20% within the state of Washington from terminating a contracted chiropractor without cause.
207 Petition

207 Proposed Rule
208. Require health carriers with a market share in excess of 20% within the state of Washington to contract with qualified chiropractors in the service area of the plan.
208 Petition

208 Proposed Rule

DOH's Response to Cross-Filed Petitions >>

WSCA's counter response to DOH >>


Exhibits
DOJ complaint Aetna Texas
Excellus Summary AG Agreement
Hawaii Coalition Antitrust 9th Circuit
All Products Clauses Fade From Physician Contracts
(Managed Care Magazine, August 2000)
The Puzzling Popularity of the PPO
Landmark Agreement with Aetna US Healthcare
Kentucky OIC Provider Contract Policies
Nevada Unfair Trade Practices
Physicians News, All-Products Clauses


Contact Information:
Lori Bielinski, Executive Director
Washington State Chiropractic Association
21400 Int'l Blvd. Ste. 207
SeaTac, Washington 98198
Ph: (206) 878-6055 | Fax: (206) 878-8699
Email: wsca@chirohealth.org
www.chirohealth.org

 



Quicklinks

OIC Petitions

OIC Response

WSCA Counter Response


DOH Petitions

DOH Response

WSCA Counter Response


Exhibits

Contact Information

 

 
WSCA - 21400 International Boulevard Suite 207 SeaTac, WA 98198 206-878-6055